Back Pain: An Ounce of Prevention

It’s important for everyone, but especially anyone with a history of back problems, to take steps to reduce the risk of damage to the spine and related structures. In addition to exercise, these steps can help.

Improve posture

Contrary to what some people may still believe, standing at attention like a military recruit—with the head and shoulders rigidly pulled back and the lower back excessively arched—is not good posture and is actually hard on the back. Good posture takes advantage of the natural S-shaped curve of the spine. Poor posture can strain back muscles and ligaments.

To evaluate your posture, stand with your arms hanging loosely at your sides. Your weight should be distributed evenly between the front and back of your feet, your knees should not be locked straight (that is, they should be slightly flexed), and your hands should be about midway down your thighs. To check your standing posture, have someone take a picture from the side. An imaginary vertical line down the side of your body in the photo should pass through the ear, shoulder, hip, and knee, and through or slightly in front of the ankle.

To check your posture while sitting, have someone photograph you while you’re sitting in an armless chair. Looking at the photograph, you should be able to visualize a line running through the same points of your upper body down to the center of your hip.

Posture varies with age. As people get older and lose height because of disc changes, the curve in the lumbar region of the back tends to straighten, leading to a slight stoop, which is normal. In addition, the curve in the thoracic region tends to become accentuated with age.

For prolonged sitting, get an adjustable chair with good back support and armrests. Sit with your shoulders against the chair, your chest lifted, upper back straight, and pelvis tucked behind you. Put a small lumbar roll against your lower back for additional support. Keep equal weight on your left and right buttocks. Your feet should be flat on the floor, and your thighs horizontal. If the chair is too high for this, use a fat book or small stool as a foot rest. Take frequent breaks.

When working at a desk, lean forward at your hips, bringing your trunk forward, rather than bending at the waist or neck. Don’t look directly down at your work.

When driving, adjust your seat position so that your knees are slightly higher than your hips and in a position that allows you to comfortably reach the steering wheel, brakes, and accelerator. Shift your hand position on the steering wheel frequently to minimize stress on the muscles in the upper back and neck.

When in bed, lying on one side with knees bent and a pillow between them helps maintain the natural curves of the spine. If you sleep on your back, place a pillow under your knees to reduce spinal pressure.

Avoid back strain

In addition to posture and exercise, many other aspects of your daily life influence the health of your back. Some people simply need to improve the techniques they use to perform everyday activities—lifting heavy objects, playing sports, or even getting in and out of a chair, for instance. Other people will need to avoid certain activities altogether.

To lift something safely, bend at your knees and hips (not waist), keep your back straight, and lift the object close to your body. The farther away from your body you hold the object, the more pressure is placed on your spine. Holding an object at arm’s length can increase the load on the lower spine by up to 15 times the object’s weight.

Depending on the severity of your back problem, you may need to stay away from activities that require sudden twisting movements. Still, if your doctor approves, you may be able to continue some of these activities as long as you modify your technique. In golf, for example, it would be important to minimize twisting movements during your swing. In addition, it would be important to keep your knees bent and spine straight when placing a ball on the tee or picking it up from the cup.

Maintain a healthy weight

Obesity places an extra burden on the lower back. It also increases the natural curve of the lumbar spine, forcing the vertebrae to bear weight at abnormal angles.

If you smoke, quit

Studies show that cigarette smoking decreases blood circulation in the intervertebral discs and speeds their degeneration. Smoking is also a major risk factor for osteoporosis and bone fractures.